Patient's question:
My daughter is a little over five years old. Recently, she has been experiencing persistent itching in her external genital area and anus. She unconsciously scratches it while sleeping. She also urinates frequently but with small amounts each time. When taken to the hospital for examination, it was diagnosed as leukoplakia of the vulva. My wife also has leukoplakia, and the doctor suspects it is hereditary. I am very anxious and worried that it may affect her development and growth. Could you please advise on how to treat it, whether it will affect her development, and what precautions should be taken?Doctor's answer:
Vaginal leukoplakia refers to epidermal hyperplasia caused by lesions, loss of pigment in the basal epidermal layer, and reduced blood vessels in the superficial dermis, leading to a decrease in color or white appearance of the vaginal skin or mucosa. Women diagnosed with "vaginal leukoplakia" often fear that it may be a precancerous lesion. In recent years, extensive clinical studies have confirmed that its canceration rate is only about 2%. In 1975, the International Society for Vulvar Diseases decided to discontinue the term "vaginal leukoplakia" and refer to the condition as "vaginal leukoplakia" or "chronic vulvar dystrophy."Patients with white vaginal skin often remain unaware due to the lack of sensation, and the condition is typically discovered by a doctor. Some patients, however, may notice the change during a visit to the clinic due to vaginal itching.
Why does the vaginal skin turn white? The exact cause remains unclear, but it is relatively well understood that when the vaginal skin is affected by certain diseases, excessive keratinization occurs in the epidermis of the affected area, and the reduction in melanocytes leads to paler skin. The affected skin may thicken like leather, or it may become thin, dry, and prone to cracking, even developing ulcers or hard nodules.
If the vaginal skin turns white, whether it itches or not, it is advisable to seek medical examination. Particular attention should be paid if the skin is thickened, rough, elevated, ulcerated, cracked, or forms hard nodules. Surgical treatment may be necessary if needed.
Since "vaginal leukoplakia" is a relatively persistent condition, long-term treatment and regular follow-up are essential. Follow-up visits every 3 to 6 months are recommended. With consistent treatment, generally satisfactory results can be achieved.
Medications such as vitamin supplements may be taken. If severe vaginal itching affects sleep, mild sedatives can be used. Locally, 1% hydrocortisone and 1–2% testosterone cream can be applied. This treatment should be maintained for 6–8 weeks, with applications 3–4 times daily.
During long-term treatment, it is crucial to maintain vaginal cleanliness and dryness, avoid tight underwear, and avoid wearing non-breathable synthetic underwear. Additionally, reducing the intake of allergenic foods is highly necessary.